“It was sent to Dr. Gorevale when Claudia decided to pursue a private course of treatment with him. Dr. Gorevale was banned from this facility, but we still referred some of the particularly difficult opiate-addiction cases to him.” Zelda’s blue eyes were watery. “You have to understand, these are incredibly difficult cases. Most of them can’t get through the physical withdrawal, and they stand no chance of getting well if they don’t. It’s a desperate situation, and it calls for solutions that aren’t open to us legally.”

Bruxton ignored her explanation. “Did Gorevale ever send that file back?” Zelda shook her head. “So all that information is gone?”

Zelda nodded. “You’re not going to bring the police into this, are you? I need your assurance—”

“I need to know what’s missing from the file,” said Bruxton.

“The contents would be similar to what you see there. Notes from her psychologist, from her counselor, from the doctors.”

“Her counselor?” I asked. “Trina Greene would have made notes about my sister?”

“Well—yes.”

“What about what isn’t reported?” asked Bruxton. “What was Claudia’s state of mind when she left this place?”

“She was distraught when she left.”

“Distraught?”

“We all found out that morning that Dr. Gorevale had died,” said Zelda. “It was a terrible, terrible shock. Claudia was, I believe, very close to him.”

“Close… to him.” Bruxton dragged out the words suggestively.

“Claudia had a very difficult time when she came here in the spring,” said Zelda. “There are some people that the replacement therapies don’t work for, and I’m afraid your sister was one of them. Alec was her last resort for treatment.”

“She had him knock her unconscious for days while she went through withdrawal?” I asked.

“That method has worked for many people,” Zelda answered quickly, sitting up straighter. “It’s used in conjunction with naltrexone, as it is in Europe. It is not some sort of unproven fringe therapy.”

“But it is an illegal one,” said Bruxton. “What are the side effects?”

“You have to understand, there are upsides and downsides to every course of treatment,” said Zelda. “Methadone, the most common, is itself an addictive drug. You must lower the dosage over the course of several months, but even the slightest change in dosage can cause physical agony. With rapid detoxification, you avoid basically all of the physical withdrawal symptoms. But…”

“But…” I prompted.

“The psychological addiction to heroin is very powerful. Unfortunately the therapy does not address that.”

“So what happens?”

“Well, if a patient is closely monitored by their doctor, and has a supportive environment, and counseling, they have the conditions necessary to combat serious addiction.”

“And what if the patient was having an affair with her doctor?” I asked.

“Then her recovery would be… fragile,” Zelda said.

“So Claudia Moore left here, distraught, on September twenty-ninth,” said Bruxton. “Where was she going?”